More on Diabetes Surgery: Surgical Treatment for Type 2 Diabetes

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More on Diabetes Surgery: Surgical Treatment for Type 2 Diabetes

Gastrointestinal Metabolic Surgery

Diabetes Surgery: Surgical Treatment for Type 2 Diabetes

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The term bariatric is derived from the Greek word 'baros' for weight. Bariatric surgery was originally developed to achieve substantial and sustained weight loss as a treatment for severe obesity. It involves various surgical procedures on the gastrointestinal tract to decrease food intake and modify the physiological changes that drive weight regain. Given the increasing evidence that some bariatric procedures provide metabolic changes that cannot be completely explained by their effects on body weight alone, the name 'metabolic surgery' is emerging as a more appropriate term. When used with the specific intent to improve diabetes this surgery is also now being referred to as "diabetes surgery".

In severely obese individuals, surgery can cause "remission" of diabetes in the majority (normal blood sugars without medications) and significant "improvement" in blood glucose in others (improved blood sugars with lesser medication).

Approximately, 40-50% of morbid obese and diabetic patients who have laparoscopic gastric banding achieve remission of type-two diabetes. With gastric bypass or biliopancreatic diversion, the rate of remission is reported to be superior ~ 70-80%.

In addition to providing excellent control of diabetes and weight loss, gastrointestinal metabolic surgery has several additional benefits, including improvement of hyperlipidemia, hypertension and sleep apnea. Moreover, the incidence of cancer is reduced in obese patients who have had bariatric surgery. Most importantly, several reports have consistently shown that in patients with diabetes and severe obesity, surgery increases long-term survival.